Invoice Orthodontist in Afghanistan Kabul –Free Word Template Download with AI

Specialized Dental & Orthodontic Center

Address: 12th Floor, City Center Tower, Shahr-e-Naw District

Kabul, Afghanistan

Tel: +93 (0) 20 123 4567 | Email: [email protected]

Tax Registration No: AF-TAX-99887766

Invoice Number: INV-KBL-2023-0892

Date of Issue: October 24, 2023

Due Date: November 07, 2023

Payment Status: Pending

Bill To:

Patient Name: Mr. Ahmad Rahimi

Account Number: PAT-445566

Address: House 45, Street 12, Karte-e-Char

Kabul, Afghanistan

Phone: +93 (0) 70 987 6543

Service Location:

Kabul Advanced Orthodontics Clinic

Shahr-e-Naw, Kabul

Afghanistan

#	Description of Orthodontic Services	Date of Service	Quantity	Unit Price (AFN)	Total (AFN)
1	Initial Comprehensive Orthodontic Consultation Includes panoramic X-ray analysis, digital impressions, and treatment planning for malocclusion correction.	Oct 10, 2023	1	2,500.00	2,500.00
2	Fixed Metal Braces Installation (Full Arch) Supply and bonding of high-grade stainless steel brackets and archwires for upper and lower jaws.	Oct 12, 2023	1	45,000.00	45,000.00
3	Orthodontic Adjustment & Progress Check Monthly adjustment session including wire tightening and elastic band replacement.	Oct 20, 2023	1	1,500.00	1,500.00
4	Emergency Orthodontic Repair Replacement of loose bracket on upper right canine due to accidental trauma.	Oct 22, 2023	1	800.00	800.00
5	Professional Dental Prophylaxis (Cleaning) Essential hygiene cleaning around orthodontic appliances to prevent gingivitis.	Oct 24, 2023	1	1,200.00	1,200.00

Subtotal: 51,000.00 AFN Discount (Loyalty Program): -1,000.00 AFN Tax (5% VAT): 2,500.00 AFN TOTAL DUE: 52,500.00 AFN

Amount in words: Fifty-Two Thousand Five Hundred Afghan Afghani only.

Payment Terms & Conditions

This invoice is issued by Kabul Advanced Orthodontics for the professional orthodontic services rendered to the patient listed above. Payment is due within 14 days of the invoice date. Late payments may incur a penalty fee of 2% per month.

Accepted Payment Methods:

Cash (AFN or USD) at our Kabul clinic reception.
Bank Transfer to Kabul Bank (Account No: 1234-5678-9012).
Mobile Banking via M-Paisa or Awal (Number: 070-1234567).

Please reference the Invoice Number (INV-KBL-2023-0892) when making any payment. Orthodontic treatment is a long-term commitment; please ensure all financial obligations are met to continue scheduled adjustments.

Authorized Signature

Dr. Farid Noorzai, DDS, MS Orthodontics

Kabul Advanced Orthodontics

Patient/Guardian Signature

Acknowledging receipt of invoice and services.

⬇️ Download as DOCX Edit online as DOCX

Create your own Word template with our GoGPT AI prompt:

GoGPT